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Tag: women’s hormones

Mini Pause #75: Hair Loss In Midlife (And What You Can Do About It)

Posted on by stephanie-estima

TL; DR (Too Long; Didn't Read)

Yes, hair loss in midlife is super common—and yes, it can still feel completely devastating.

Your ponytail gets thinner, your scalp feels more visible, and your bathroom floor starts to look like it’s wearing a wig.

What’s going on? Hormones are shifting, follicles are aging, and your hair’s natural growth cycle is slowing down.

BUT (and this is a big but), there are things you can do to help. Red light therapy, hormone support, and follicle-loving nutrients and products can bring your strands back to life.

WHY

Let’s Talk About WHY It’s Happening. Hair thinning or loss during perimenopause and menopause is incredibly common—and honestly, pretty upsetting.

You might be surprised to know that by the time you notice thinning, you’ve probably already lost about 50% of your hair volume.

Wild, right? Knowing why this happens makes it easier to take action—and feel more in control.

WHAT 

How Hair Actually Grows (and Falls Out)

Your hair goes through three main phases:

  • Anagen (Growth) – This is your hair’s growth mode.
  • Catagen (Transition) – Growth slows, and your follicle prepares to shed.
  • Telogen (Resting) – The strand falls out, and the follicle chills before starting over.

When we’re younger, the anagen phase can last years, thanks to high estrogen levels keeping our hair long, thick, and shiny.

But as estrogen and progesterone decline in midlife, that growth phase gets shorter. Hair starts falling out faster than it can grow back—and that makes long, full hair much harder to maintain.

Meet the Hair Wreckers: Hormones + Senescent Cells
So, what’s really messing with your hair?

  • Hormonal Decline: As estrogen and progesterone dip, the growth cycle shortens. Hair gets thinner, and new growth struggles to keep up.
  • Senescent Cells: These are aging cells that stop functioning but stick around causing inflammation. Around your hair follicles, they create the perfect storm for shedding and thinning.

I recently interviewed Alessandra Zonari, stem cell biologist and co-founder of OneSkin, on the BETTER! podcast. She and her team developed a peptide that helps clear out those senescent cells around hair follicles—and guess what?

I’ve been using their OS-01 Hair Serum consistently for 8 weeks and I’ve got baby hairs coming in. Amazing, right?

 

HOW

What Can You Do? Let’s get to the good stuff: how to help your hair thrive in midlife.

  • Red Light Therapy
    This is one of my favourite biohacks. Red light helps energize hair follicles, reduce inflammation, and can even help your body clear senescent cells. I personally use BonCharge Red Light Panels and aim for 10–20 minutes daily.
  • Load Up on Minerals
    Your hair loves nutrients. Make sure you’re getting plenty of:
    ✔️Iron – Helps deliver oxygen to follicles. (Red meat, lentils, spinach)
    ✔️Zinc – Needed for follicle repair. (Pumpkin seeds, beef, seafood)
    ✔️Magnesium – Boosts hair strength. (Almonds, avocado, leafy greens)
    ✔️Selenium – Protects against damage. (Brazil nuts, fish, eggs)
    ✔️Silica – For shine and resilience. (Oats, cucumbers, bananas)
    ✔️Copper – Supports pigment and density. (Mushrooms, nuts, seeds)
  • Clean Up Your Haircare Routine
    Ditch harsh shampoos and heat styling (or at least go easy). Use products that target aging follicles and support healthy growth. OneSkin’s OS-01 Hair Serum is a game-changer—especially if you’re trying to rescue thinning areas.

NOW

What To Do Next (AKA Your Hair Rescue Plan)

✨ Start Red Light Therapy – Try 10–20 minutes a day. It’s relaxing and restorative.
🥗 Eat for Your Hair – Prioritize protein, good fats, and those follicle-loving minerals.
🧴 Use Smarter Products – Swap in serums like OS-01 Hair that support cellular repair and follicle rejuvenation.

WHAT I RECOMMEND

OneSkin OS-01 Body  

Bettys, you know I always say: your skin isn’t just something you moisturize—it’s your largest organ and a vital part of your metabolic and inflammatory health. That’s why I’m obsessed with OneSkin’s OS-01 BODY. This isn’t your average body lotion—it’s a topical longevity treatment formulated by scientists to actually reverse biological aging in your skin cells.

In clinical studies, it increased skin thickness by up to 40%, dramatically improved hydration, and even lowered markers of systemic inflammation. Translation? Smoother, firmer skin and deeper health benefits you can feel.

If you’ve got crepey arms, a dull chest, or thinning skin on your legs, you’ll want to read this. → Click here to learn how it works.

And if you want to see the results for yourself, use DRSTEPHANIE at checkout to save 15%!

 

Strengthen Your Foundation with Peluva 

As women age, the risk of falling—and suffering serious injuries like fractures—rises dramatically. In fact, falls are the leading cause of ER visits in women over 65!

But here’s the good news: there are simple things you can start doing today to protect your future mobility. One of the most important? Improving your proprioception, which is your body’s ability to sense where it is in space. It’s what keeps you balanced, coordinated, and steady on your feet.

One easy way to boost proprioception is by wearing barefoot or minimalist shoes. Unlike conventional shoes that weaken your feet and limit natural movement, barefoot shoes help activate the small stabilizing muscles in your feet.

My absolute favourite? Peluva’s barefoot shoes. (I own three pairs!) They’re cute, comfy, and actually work to strengthen and realign your feet with every step. Whenever I wear them, I feel more confident in my stride and know that I’m improving my long-term mobility and independence.

Want to give them a try? Use code DRSTEPHANIE at peluva.com/DRSTEPHANIE for 10% off.

🌟 Love these recommendations? Find more resources to support your health in midlife in my Health Toolkit!

Mini Pause #74: Sports for Longevity

Posted on by stephanie-estima

TL; DR (Too Long; Didn't Read)

I am all about a life well-lived.

I have been intrigued recently about sports that increase and improve longevity, and delightfully, sports like tennis, pickleball, badminton, squash, and cross-country skiing are among this list.

They can significantly boost longevity by improving cardiovascular health, enhancing cognitive function, supporting muscular strength, and, perhaps most importantly, fostering social connections.

WHY

A few weeks ago – I was playing tennis one morning and got to speak with one of the players in the court next to me after our session. He is 75, plays 5 days a week for 2 hours a day. I was literally in awe of him (and his serve!)

The same thing has happened to me on the cross country trails in the winter. I am lapped by smiling elderly women and men who are just flying through the course.

They are potent reminders of how I want to age. And if they have figured it out by playing tennis or skiing, I am all over it.

Movement diversification is a crucial element to aging well. Just like a diversified financial portfolio can protect our investments, movement diversification is also important.

What makes these sports so special is they specifically combine multiple factors associated with aging well:

  • Aerobic exercise
  • Coordination
  • Strength
  • And social interaction

I would also add that racquet sports add an element of strategy. You have to be thinking about setting up to hit the ball well, but also what you can hit that wins points. It keeps you mentally sharp.

Racquet sports also use a lot of side to side motion. Nerds like me refer to this as the coronal plane which is sorely lacking in everyday life. This side to side motion keeps tendons and ligaments in the ankles, knees and hips healthy, and it also helps develop core strength, another crucial component for aging well.

WHAT 

Here's a fun summary of the benefits of these sports:

Racquet Sports (Tennis, Pickleball, Badminton, Squash):

    • Improves cardiovascular endurance and heart health.
    • Enhances cognitive skills such as strategy, quick decision-making, and hand-eye coordination.
    • Strengthens major muscle groups, maintaining overall muscular health.
    • Fosters social connections, reducing stress and promoting mental health.

That last point, while simple, is hard to overlook. It's simply a delight to have friends who share the same interest as you, and you can connect while exercising together. In this way, pickleball or tennis is the medium by which you are connecting with others, and getting a good workout is just a side benefit.

Cross-Country Skiing:

    • Superior aerobic conditioning and cardiovascular health due to full-body engagement.
    • Low-impact activity preserving joint health.
    • Enhances balance, coordination, and core strength, which are crucial for injury prevention and daily functional activities.

If I may be so bold (and expect more on this in the future), with all the hype around muscle, what seems to be lost is that in order to age well, you MUST, I repeat, MUST preserve your joints.

You can’t develop muscle if the joint is destroyed.

Joints are the unsung hero of aging well. No joints, no muscle. Period.

This is why I love cross country skiing over all other types of skiing. The injury risk is so low, the impact is low, and it is just you, the sound of snow crunching under your feet, and the random sounds of birds, and babbling brooks that have not yet frozen over. It is heaven on earth.

 

HOW

If you are a gym girlie like me and perhaps looking to diversify your movement portfolio in your training sessions, you can also integrate some sport specific training for these sports to augment your physical literacy required to do them well.

For Racquet Sports Training:

    • Agility drills (lateral movements, footwork patterns on a ladder are great).
    • Strength training emphasizing legs, core, and shoulders (lunges, rotational core exercises, overhead presses, Pilates).
    • HIIT and jump training to boost speed and power (think switch lunges, jumping squats, or one footed jumping patterns on and off plyo boxes
    • Balance exercises to prevent falls and improve court mobility.

Cross-Country Skiing Training:

    • Endurance training through steady state running, cycling, or rowing.
    • Core stabilization exercises (planks, side planks, Russian twists, Pilates).
    • Upper-body strength training (pull-ups, push-ups, rowing movements).
    • Balance and coordination drills, including single-leg balance and proprioceptive exercises.

NOW

Your easiest 3 next steps:

1. Try a Beginner Session: Find local clubs or groups to try these sports.

2. Add Cross-Training: Start with simple strength or balance routines to complement the sports.

3. Commit Socially: Engage a friend or group to enhance motivation, enjoyment, and accountability.

 

WHAT I RECOMMEND

Red Light Therapy for Face & Neck 

Your skin doesn’t lie. As estrogen dips during perimenopause, changes in your face and neck can feel sudden and defeating.

But what if a simple, at-home light ritual could visibly brighten your complexion and help you sleep better?

Learn why red light therapy is more than a skincare trend—it’s a hormone-friendly tool to support your entire body through the midlife shift.

Click here to dive into the research and how-tos in our latest article.

 

Maui Nui Venison Snacks

If you’ve ever wished for a high-protein snack that supports your hormones and your metabolism without weighing you down—this is it.

I’ve found a protein source that checks every single box for us midlife Bettys: wild-harvested venison sticks from Maui Nui. With an unbeatable protein-to-calorie ratio (10g of protein in just 55 calories!) this lean, seriously delicious meat outperforms conventional beef in every way—more micronutrients, better blood sugar support, and none of the inflammatory junk.

Plus, Maui Nui is dedicated to safe and sustainable practices; both the animals and the land they graze on are treated with the utmost respect.

Click here to learn more about my #1 protein go-to snack. (Both myself and my family are obsessed with them!)

By the way, supplies are limited by the nature of their work, so they sell out FAST.

 

LMNT's Lemonade Salt

It's easy to forget that our sweat isn't just water. But why is it that we only down a glass of water after finishing a workout or running around on a hot day? Our sweat consists of water and sodium, potassium, and magnesium.

So next time you're reaching for that glass of water … remember to replenish electrolytes too.

My new summer hydration obsession is LMNT's Lemonade Salt. With zero sugar, artificial ingredients, or junk found in conventional sports drinks – and with the right amount of minerals – it checks all the electrolyte boxes. I feel hydrated and more energized within minutes of taking it. Plus I love LOVE the taste!

Click here to grab this new flavor and get a free Sample Pack with your purchase.

Hurry, though, this flavor is only around for a few more weeks!

 

 

 

🌟 Love these recommendations? Find more resources to support your health in midlife in my Health Toolkit!

Mini Pause #73: Pelvic Floor Health in Midlife

Posted on by stephanie-estima

TL; DR (Too Long; Didn't Read)

Pelvic floor health significantly impacts midlife women's quality of life, affecting issues like urge, stress, and fecal incontinence.
It is the number one predictor for entrance into a nursing home. More than sarcopenia, osteoporosis or any other health risk we typically think of for women.

WHY

The pelvic floor is a powerful group of muscles that supports your bladder, bowel, and uterus. Yet, many women are unaware of its importance until problems arise. Conditions like urinary urgency, leaking when sneezing or coughing, fecal incontinence, and constipation are common, significantly impacting daily comfort and confidence.

The pelvic floor muscles differ from say, a bicep muscle, in that they are ALWAYS working. They are part of your core muscles, and literally keep your organs from falling out.

WHAT 

  • Urge Incontinence: A sudden, uncontrollable need to urinate, often associated with weakened pelvic floor muscles or bladder irritation.  It can almost feel like a Pavlovian response, like having to pee the second you come home, or washing your hands under water.
  • Stress Incontinence: Leaking urine during activities that put pressure on the bladder, such as coughing, sneezing, jumping, or laughing.
  • Fecal Incontinence: Inability to control bowel movements due to weakened pelvic floor muscles or nerve damage.
  • Pregnancy and Delivery: Hormonal changes and physical strain during pregnancy and childbirth can stretch and weaken these muscles.
  • Hormonal Changes: Declining estrogen and testosterone in perimenopause lead to reduced muscle tone, elasticity, and tissue integrity. Note, when I say tone here I mean it to represent the neuromuscular integrity of the muscle.  Meaning, the strength (or lack of strength) in which the nerves are innervating and powering up the muscles.  I am definitely NOT referring to fitness influencer word salad that roughly translates to “looking in shape”.
  • Tight Pelvic Floor: Chronic tension or hypertonic pelvic muscles can lead to constipation, difficulty emptying the bladder or bowel, and discomfort during intercourse.

HOW

  • Tight Pelvic Floor: Chronic tension or hypertonic pelvic muscles can lead to constipation, difficulty emptying the bladder or bowel, and discomfort during intercourse
  • Kegel Exercises: Strengthen weakened pelvic floor muscles to reduce stress and urge incontinence. Practice consistently and with correct technique. For the record, I prefer the term Puss-Ups. These exercises are essentially a contraction of the pelvic floor muscles (think about pulling “in” and “up”), an isometric hold, and then a release.
  • Hypopressive Exercises: Gentle abdominal breathing and postures that reduce intra-abdominal pressure and naturally strengthen the pelvic floor. I absolutely love these. Lying on your back, on an inhale, pull the navel “up and under” the ribcage, as if you were trying to bring it towards the spine. Hold for several seconds and release.
  • Relaxation Techniques: Diaphragmatic breathing, yoga, and guided pelvic relaxation exercises can ease tension in an overly tight pelvic floor. I am a big fan of child’s pose, or happy baby pose in yoga for this.
  • Proper Toilet Posture: Using a squatty potty or raising your knees helps relax pelvic floor muscles, making bowel movements easier. This helps to relieve strain, align the sacrum and coccyx (the tailbone) and reduce transit time of the bowel movement.
  • Physical Therapy: Specialized pelvic floor physical therapy can provide targeted exercises, biofeedback, and manual therapy to balance strength and flexibility.

NOW

  • Assess your pelvic floor: Notice symptoms like leaking, urgency, constipation, or discomfort. Discuss these with your healthcare provider. I want to acknowledge that this topic is cloaked in shame and it may be difficult to discuss what is happening with someone. However, I am going to firmly encourage you to ensure this discussion takes place. Left unmanaged, incontinence only gets worse, the strength of the muscles will continue to weaken without a proper therapist, program or proper hormones.
  • Implement a pelvic health routine: Integrate daily Kegels or relaxation exercises, depending on your specific needs. There are apps that you can download that also can be a great companion to strengthen your pelvic floor daily!
  • Consult a specialist: Seek support from a pelvic floor physiotherapist for personalized assessment and tailored treatment.

What I Recommend

The Midlife Protein Trap: Why You’re Eating Right But Still Feeling Off

Feeling bloated, tired, or like your metabolism hit the brakes? It might not be your hormones (or at least, not just your hormones).

In my latest article, I reveal the hidden digestive issue that’s quietly wrecking your protein absorption, energy levels, and muscle tone during perimenopause. This one’s a game-changer, especially if you’ve been upping your protein but still feeling off. I also share my go-to solution that’s helping women feel stronger, leaner, and less gassy (you're welcome).

Get all the facts and my top recommendation by clicking here.

 

MassZymes

If you’re looking for digestive support during perimenopause and menopause, then check out MassZymes by BiOptimizers.

It is a 100% plant-based, full-spectrum digestive enzyme that helps your body break down protein more efficiently (so you actually absorb the nutrients you’re eating). Many women report less bloating, more energy, and improved recovery after meals and workouts.

Visit BiOptimizers and use code ESTIMA to get 10% off your order.

 

AG1 Big Update Alert!

I’ve been drinking AG1 for years as it’s the absolute easiest way to supplement my diet on the go. I never have to worry if I’m getting all my bases covered because they are if I’m drinking this.

If your schedule is often too packed to prepare meals that give you all the whole foods, vitamins, minerals, and probiotics you need, AG1 is your answer. It’s incredibly clean, nutritious, delicious, and is meant to be enjoyed daily.

I’m so thrilled to see AG1 raise the bar (again) and can’t wait for you to try their Next Gen formula…

Head to drinkAG1.com/stephanie to try the new formula and get a FREE Welcome Kit, a bottle of AG D3K2, and 5 upgraded travel packs with your first order.

 

🌟 Love these recommendations? Find more resources to support your health in midlife in my Health Toolkit!

Unlocking the Secrets of Nervous System Regulation for Women in Midlife

Posted on by stephanie-estima

As women transition into their perimenopausal and menopausal years, they often experience myriad symptoms that can disrupt daily life and make them feel unlike themselves. It can be a turbulent time — physically and emotionally. These symptoms are frequently rooted in hormone imbalances, from stress and weight gain to brain fog and sleep disturbances.

And while hormones tend to take center stage, another important player often overlooked is the nervous system. Understanding and regulating your nervous system can help you unlock better health, energy, and overall vitality.

Understanding the Nervous System

The nervous system is your body's command center. It regulates everything from your heartbeat to your ability to handle stress. During menopause, hormonal fluctuations upend this delicate balance.

An overactive sympathetic nervous system causes a chronic release of stress hormones like adrenaline and cortisol, making your breathing shallow and fast, sending your heart rate up, and diverting all available resources like blood and oxygen to your heart, lungs, skeletal muscle systems, and amygdala (the fear center of your brain) to get you out of harm's way.

Since you only have so much blood and oxygen to go around, all the systems that aren’t responsible for survival in those moments–like digestion, reproduction, immunity, and even emotional regulation–get deprioritized to ensure you get to safety.

This is how humans survived over time; our nervous system evolved to prevent us from falling asleep or thinking about reproduction when a threat is nearby (bear! lion!).

Nervous System and Hormone Imbalance

Estrogen, a key hormone that declines during menopause, significantly impacts the nervous system. This decline can lead to heightened stress responses and disrupted sleep patterns. It's not just about feeling stressed or tired; these changes can exacerbate other menopausal symptoms like weight gain and brain fog.

Regulating Your Nervous System

Fortunately, there are several strategies to help regulate your nervous system:

  • Mindfulness & Meditation: Regular mindfulness practices can reduce stress and improve your body's response to hormonal changes. Simple techniques like deep breathing or guided meditation can be powerful tools.
  • Exercise: Physical activity, especially yoga and aerobic exercises, can help regulate the nervous system. They not only improve muscle mass and energy levels but also enhance your mood and sleep quality.
  • Nutrition: Foods rich in omega-3 fatty acids, magnesium, and B vitamins support nervous system health. Incorporating these into your diet can aid in managing stress and improving overall well-being.
  • Sleep Hygiene: Prioritizing sleep is crucial. Establish a regular sleep routine (also known as sleep hygiene), limit screen time before bed, and create a calming bedtime environment.
  • Supplementation: Certain supplements, under the guidance of a healthcare professional, can support nervous system health. These might include adaptogens, magnesium, or omega-3 fatty acids.

Products That Support Nervous System Health

When considering products, look for those that support the strategies mentioned above. Whether it's a meditation app, a yoga mat, or a high-quality supplement, each product should align with the goal of nervous system regulation and overall well-being.

I started doing yoga regularly at the start of 2024 and it’s been wildly beneficial for me. I now attend yoga classes regularly several times a week. Try what works for you–perhaps you’d like to explore the serenity of meditation or supplements that can guide you into a calmer state.

One of my favorite products that helps to regulate the nervous system is the Apollo wearable, especially because it was created by neuroscientists and physicians. It delivers gentle, soothing vibrations that help the body switch from “fight or flight” to a more “rest and digest” parasympathetic state.

Apollo is designed to offer the benefits of mindful practices like meditation and breathwork through your body’s natural response to touch. It also can improve your deep sleep, REM sleep, and total sleep time. (And I’ll keep saying this: Getting better quality sleep is absolutely essential to managing your peri and meno symptoms!)

Navigating the perimenopausal and menopausal years doesn't have to be such a struggle. By understanding and caring for your nervous system, you can significantly impact your health, vitality, and quality of life. Remember, small, consistent steps can lead to big changes.

I’m always looking for affordable items for my Bettys who want to uplevel their health.  If you choose to invest in an Apollo wearable to help manage your nervous system, click HERE. A DRSTEPHANIE 15% discount will be automatically applied at checkout for you.

***

Disclaimer: The information included in a newsletter, email, or on drstephanieestima.com is intended solely for educational purposes. It does not replace a direct relationship with your licensed medical provider and is not intended to diagnose, treat, cure, or prevent any disease.

Affiliate Disclosure: Products mentioned in a newsletter, email, or on drstephanieestima.com, may be part of an affiliate agreement in which Dr. Stephanie Estima receives a small commission on the sale of an item you purchase.

Mini Pause #11: Speeding Up & Going Hard: Zone 6 Training Benefits

Posted on by stephanie-estima

Note: In the Mini Pause #10 email, some new formatting got the best of us and a few essential links were missed. Here’s the polar heart rate monitor I mentioned. And all [*] reference links are now fully functional in the web edition.

Speed Up Your Cardio: Why Zone 6 Training (Yes, Sprinting!) is Essential to Your Fitness

TL,DR (too long, didn't read)

In addition to working your base with Zone 2 training, you also want to be training your top end to preserve your power and speed. This type of training biases training of the type 2 fibers. There are three main ways you can train your fast twitch fibers: 1) speed training, 2) plyometrics, and 3) resistance training. We’ll explore each of these in the coming weeks. Today, we explore how to structure speed training into your current cardio regimen.

WHY

In Mini Pause #8, I discussed the importance of Zone 2 training for mitochondrial and cardiovascular health in menopause. We received hundreds (and hundreds!) of questions asking about where sprinting training comes in. So that’s the subject of today’s issue! Ya girl always has your back.

While Zone 2 training should make up the base of your cardiorespiratory work, it’s essential to train the top end of your cardio range, too.

As early as your mid-20s (I know…good grief!), you start to lose your fast twitch muscle fibers (aka the muscle fibers that contract quickly and primarily use glucose as their fuel source) at a rate of 1 percent per year.

As you move through perimenopause, the loss of estradiol contributes to a loss of muscle satellite cells [*]. Satellite cells are muscle stem cells that are responsible for muscle regeneration and adaptation. As you lose these cells, it becomes harder to grow and repair your muscles.

There are several ways to train type 2 fibers. Over the next couple of weeks, we’ll focus on two main ones: speed training and plyometrics.

WHAT

Speed Training / Sprinting

Sprinting is one of my favorite ways to train up type 2 fibers. It’s available to everyone. All you need is a pair of trainers and a road.

True sprint is something you can do ALL OUT for 10 to 30 seconds. No more. There are a few reasons for this.

1: In order to sprint, there are several energy systems involved depending on the length of time you’re doing it. The longer you’re sprinting, you will, by necessity, be gearing down into slower energy production systems. Meaning – also by necessity – that your sprint will be getting slower.

The first 5 to 10 seconds of any sprint is going to be fueled by the phosphocreatine system [*][*].

At that 5-10 second mark, you peter out of this energy system. This is a short-lived system with the energy to power your muscles coming mainly from the stored energy within the muscle itself.

Think about the excitement of a 100-meter dash at the Olympics; they are only tapping into their phosphocreatine system!

After about 10 seconds, you move to an energy system called glycolysis. You’ll notice your sprint markedly slows at this junction point. Glycolysis, when you are still sprinting, peters out around a maximum of 20 seconds after that.

Think about the 200-meter dash at the Olympics; the first half of the sprint is the phosphocreatine system and the second half is glycolysis. When you’re watching the Olympics in Paris this year, you will no doubt be thinking about this little factoid.

2: The second reason for keeping an all-out sprint under 30 seconds is psychological. If you know you’re going to be sprinting for one minute or 45 seconds, you’re going to “manage” your energy output to last that long.

There are several major benefits of sprint training that as a perimenopausal or menopausal woman you do not want to gloss over. They are:

ANABOLIC: When you’re sprinting all-out max power, you’ll build muscle [*]. While steady-state cardio (including Zone 2) can be catabolic, this type of training signals the muscle to develop. This happens even in a fasted state or if you don't eat for two hours after a grueling sprint. I’m not recommending you do either of these; sprint fasted or don't eat afterward. You choose what’s right for you.

But let's say you (or me on a recent Monday) wake up late, haul ass to the gym, and get your sprints in and then oops! You remember you have an important meeting in 30 minutes and don't have time to eat a proper post-meal workout. Based on the results of this study [*], that doesn’t seem to matter.The point? Sprinting is a strong anabolic (growth) signal to the muscles in the absence of food.

INCREASED TESTOSTERONE & GROWTH HORMONE: The other benefit of course is an improvement in hormonal composition, similar to what we see in resistance training. Post-sprinting, women have a greater rise in testosterone and growth hormone [*]. Both are important for lean muscle preservation, fat management, and mood. I know my Bettys want that trifecta!

HOW

Let’s keep this super simple and say your maximum sprint is going to be 10 to 30 seconds.

  • Recovery should be about the same length as the sprint, so somewhere between 10 to 30 seconds, and then repeat this anywhere from six to 12 times.
  • You can sprint on the road or on a piece of cardio equipment you like. I use my CAROL Bike and I love their “Fat Burn 30” workout. This Tabata-style cycle session features eight seconds on, 12 seconds off for recovery, repeated 30 times. I love this because it’s low impact, and I can track my progress in terms of power output over time.
    • (If you’re curious about this AI-powered bike, click the link provided and use code DRSTEPHANIE to save $100.)

NOW

Choose one day of the week and make it your sprint day. Time of day is irrelevant; just get it in when you can get it in!

  • Start with a 10-second, ALL-OUT sprint. Whatever that looks like for you. Recover for 30 seconds and repeat. Do this eight to 10 times.
  • Over the next several weeks, try to claw back your recovery so that you’re sprinting and recovering at a 1:1 ratio. Meaning, if you're sprinting for 10 seconds, you’re resting for 10 seconds.
  • Over time, you can increase your sprint and recovery by a few seconds, but max out at 30 seconds on, 30 seconds off.

Question of the Week

Q: How to tell if I’m perimenopausal? I’m 41, had hot flashes for a week and my period came eight days early.

Welcome to perimenopause, friend.

Perimenopause starts for most of us in the mid- to late-30s with a progressive and steady drop in progesterone. We can become symptomatic in our 40s (as you have), with irregular periods, raging PMS, sleep disturbances, and the onset of hot flashes and night sweats.

Many women who’ve dialed in their nutrition, exercise, and stress management can reduce and alleviate many symptoms of perimenopause. You can also consider seeking out hormone replacement therapy options.

Other signs and symptoms of perimenopause may include:

  • Heart palpitations
  • Irritability & moodiness
  • Trouble staying asleep
  • Lower sex drive
  • Vaginal dryness / poor lubrication
  • Lack of focus & poor concentration
  • Short-term memory lapses
  • Itchy skin
  • Achiness through joints and tendons
  • Slower recovery from weight workouts
  • Hair loss and hair thinning
  • Fingernails becoming more brittle
  • Dry skin, dry mouth, dry eyes
  • Sensitive teeth
  • Restless legs
  • More facial hair

While this is not an exhaustive list, you can see perimenopause is an experience of the entire body and brain.

The whole point of this newsletter is to arm my Bettys with tools to better navigate perimenopause!

YOUR TURN!

I'll be answering your questions every week right here in the Mini Pause! Let me know what's on your mind. I'll be checking for both questions and feedback at support@drstephanieestima.com.

P.S.

HEALTH TOOLKIT: I’ve compiled numerous resources for you on my brand new website. These resources are for my Bettys who are still cycling, experiencing symptoms of perimenopause, or going through the menopause transition. Some items are appropriate across each category, and some are specific for each one. Everything I recommend, I use myself. That’s my rule. I invite you to look around

Air Quality: The Silent Guardian of Your Sleep and Hormonal Health

Posted on by stephanie-estima

As women, particularly those of us over 40, we’re often vigilant about our diet, exercise, and mental well-being. Yet, there’s a silent factor significantly impacting our health that deserves our attention: the quality of the air we breathe, especially at night.

The Links Between Air Quality, Sleep, and Hormonal Balance

Air Quality and Sleep

  • The Hidden Disruptor: Poor indoor air quality can be a hidden disruptor of sleep. Pollutants like dust, allergens, and chemical vapors can irritate the respiratory system, leading to disrupted sleep patterns.
  • Deep Sleep and Clean Air: Studies suggest that cleaner air can enhance the quality of sleep by reducing the risk of airway irritation and facilitating easier breathing.

Impact on Hormonal Health

  • Cortisol Levels: Poor air quality can stress the body, leading to elevated cortisol levels, which can disrupt other hormonal balances.
  • Estrogen and Air Quality: Research indicates a link between air pollution and estrogen levels. Pollutants can mimic or disrupt hormonal activities, potentially affecting menstrual cycles and menopausal experiences.

Specific Concerns for Women Over 40

  • As we age, our bodies become more sensitive to environmental factors. Women over 40 may experience more pronounced effects of poor air quality on their sleep quality and hormonal health.

Strategies for Improving Indoor Air Quality

  • Regular Ventilation: Ensure your living spaces are well-ventilated. Open windows, when possible, to allow fresh air circulation.
  • Air-Purifying Plants: Incorporate plants like spider plants and peace lilies, which can naturally filter out common pollutants.
  • Mindful of Household Products: Be cautious about the use of harsh chemical cleaners and air fresheners that can degrade air quality.
  • Invest in a Quality Air Purification System: A reliable air purification system can be a game-changer, especially in bedrooms where you spend a significant part of your night.

My Home Experience

As a health-conscious woman and a professional dedicated to women’s health, wellness, and performance, I explored various solutions to clean the air in my family’s home. When I discovered the Jaspr Pro, I knew it checked all my “have to have” boxes.

It’s more than just an air purifier; it’s a complete home air purification system that intelligently adapts to my indoor environment, significantly improving the air quality in my home.

I learned so much about how air quality affects my overall health in my conversation on the Better! podcast with Mike Feldstein, founder of Jaspr. Take a listen to episode 349: Air Quality for Sleep, Recovery, and Brain Health.

Embracing clean air in our homes is not just about comfort; it’s a crucial step toward better sleep and hormonal health, especially for women over 40. As we focus on nourishing ourselves, let’s not forget the air we breathe is just as vital.

Learn more about how to improve air quality in your home with Jaspr. Use code ESTIMA to get an exclusive discount.

Warmly,

Dr. Stephanie

Mini Pause #6: Your Metabolism & Body Composition

Posted on by stephanie-estima

Is Your Metabolism Slowing Down as You Age? The Surprising Answer

TL;DR

Welcome to this part of the internet where we consider how both lifestyle (nutrition, muscle building) AND hormone changes contribute to body composition changes in women in their 40s and 50s.

The online debates have been spicy lately, and I’ll get in the ring with some data and clinical insights to help you better understand your changing physiology. It is not simply calories in, calories out OR just hormones.

Turns out, like most things, the truth lies somewhere in the forgotten middle.

WHY

For decades now, women have been told to “suck it up buttercup” when it comes to body changes as we age:

“This is just part of aging.”

“This is your new normal.”

“Your metabolism isn't what it used to be.”

Debates continue on the mechanism for excess and unwanted fat deposition for women in perimenopause and menopause. So many women in the Bettyverse have told me that despite dialing in nutrition and exercise they have continued to gain weight (usually through the midsection) DESPITE these efforts.

When we are told to simply eat fewer calories to compensate for the weight gain, or to increase our physical activity — this advice fails to encompass the totality of what is happening. It is part of it, but not all of it.

So is it metabolism? Is it hormones? What’s driving this persistent change in our body composition?

WHAT

Metabolism — Does it Change With Age?

Conventional thinking tells us that as children, our metabolism is elevated and reaches a peak in our mid-20s. This does not seem to be true.

This study set out to investigate the effects of age, sex, and body composition on total body expenditure and other components of metabolism. It was a nice size (6421 participants, with 64% of them female) with geographically diverse backgrounds from 29 different countries. They looked at men and women from 8 days of age to 95 years old.

A few interesting trends emerge from this study.

  • First: In the cohort of 20- to 60-year-olds, metabolism remains virtually unchanged. This remains true even during pregnancy! It is only around the 63-year-old mark that metabolism begins to decline.
  • Second: The single biggest predictor of your metabolism is directly related to your fat-free mass. For an in-depth look at FFMI, listen to my Better! podcast conversation with Dr. Tommy Wood.

Both of these findings are great news for Bettys navigating perimenopause and menopause! Why? Because it gives us a sense of agency, at least partially, over our bodies in our 40s and 50s.

The biggest predictor of your metabolism is how much muscle tissue you have (and by way of extension your bone density). That IS something you can control. Type A personalities rejoice and say it with me, “WE CAN CONTROL SOMETHING!”

However, metabolism is only a part of body composition. How many calories burned is one thing, but fat distribution, type of fat accumulation, insulin resistance, and the loss of anabolic hormones (estradiol and testosterone) contributing to the loss of lean muscle mass is quite another.

During perimenopause and menopause, your tissues become more insulin resistant as a natural consequence of aging. This makes it harder for your cells, tissues, and organs to get the nutrients they need to produce energy.

We know that insulin resistance shows up in skeletal tissue for decades despite euglycemic levels. Said another way: Your muscles can be insulin resistant for YEARS and yet, you can have normal blood sugar because your pancreas can pump out more insulin to counteract the rising blood sugar levels.

The net effect of insulin resistance is ​​fat production and accumulation in the liver (referred to as de novo lipogenesis) — also known as visceral fat. This is often the reason why women see their cholesterol levels skyrocket in perimenopause and menopause despite “doing everything the same.”

But wait, there’s more!

Declining estrogen levels during perimenopause are also part of the reason you see visceral fat distribution favored over subcutaneous fat deposition in your 40s and 50s.

The phenotype of fat literally changes during menopause where your body will preferentially begin to accumulate fat on your organs versus accumulating fat under your skin.

The fat under your skin is largely harmless despite your general disdain for it.

The fat that accumulates around your organs, however, has terrible consequences for your health including skyrocketing the development of cardiovascular disease, Alzheimer’s disease, type 2 Diabetes, cerebrovascular disease, and stroke.

There also is ample evidence that visceral fat is incredibly inflammatory. This leads to premature aging of your cells, tissues, and organs, and generally makes you feel awful.

So, you must consider BOTH lifestyle and hormonal interventions.

HOW

Lifestyle Interventions

 

1. Consider the composition of your calories.

  • In my book, The Betty Body, I detail a female–centric ketogenic diet for women looking to lose weight, and more specifically, lose visceral fat.
  • The ketogenic diet ( high fat, moderate protein, and low carbohydrate) has been shown to improve all measures of body composition including body weight, body mass index, waist circumference, fat mass, fat–free mass, lean body mass, visceral adipose tissue, and body fat percentage

2. Lift heavy weights with the intention of putting on muscle mass.

  • “Heavy” means different things to different people, but as a general guideline, the last few repetitions of a set should be very difficult.
  • You should still be able to rep out good form, but the intensity should be an 8 or 9 out of 10. Forget 3 sets of 15.
  • Work until the muscle is done like dinner.

3. Exercise snack your way through the day.

  • I detailed the utility of exercise snacks and their benefits on lipids, body composition, and overall health here.
  • We are designed to have a lot of low-grade activity throughout the day. If you are someone who sits at a desk for several hours a day, consider investing in an under-desk treadmill and a convertible desktop stand to be able to get some consistent walking through the day. It doesn’t need to be fast: 1.0–1.5 mph is plenty!

Hormone Replacement Therapy

 

  • I’m a big fan of HRT, and think this can and should be started as soon as there is evidence your body is struggling to produce adequate levels of estrogen, progesterone, and testosterone.
  • I always recommend getting blood work every six months to monitor your levels — or sooner if you think something is up.
  • Consider starting HRT in perimenopause when things go awry and plan to be on them for the long haul.
  • Don’t go it alone. Make the HRT decision in tandem with your doctor.

Bonus! Take a listen to my in-depth discussion about the Women’s Health Initiative and why it was a colossal failure for our beautiful menopausal women — check it out here.

NOW

  • Pick up a copy of The Betty Body to learn how to apply the ketogenic diet as a mechanism to reduce body weight, body mass index, waist circumference, fat mass, visceral adipose tissue, body fat percentage, and increase fat–free mass and lean body mass.
  • Book an appointment with your doctor to discuss HRT. At the very least, get some blood work done!
  • Start lifting weights intending to increase muscle mass. Intensity is key here. Work the muscle close to (but not at) muscle failure. For most women, rate your set intensity between 8 or 9 out of 10.

QUESTION OF THE WEEK

Q: Post-workout soreness: How much is considered normal? (If any?)

This is a great question! I’m going to nerd out and break this down into the different components that might be contributing to your soreness. Let’s also look at whether or not they are “common” or “normal.” Much of it has to do with different fatigue types related to recovery.

Muscular Fatigue / Soreness

This is the soreness in the muscle/muscle groups you’ve trained.

There are many reasons for muscle soreness and fatigue. The most common one being a novel stimulus. If you went to the gym on Monday, found your groove, felt like Woman Woman, and decided to either change up some exercises in your routine and/or add weight to the exercises, this can elicit soreness in your muscles.

DOMS (delayed onset of muscle soreness) can occur up to 72 hours after the stimulus as the muscle tissue repairs and remodels itself.

This type of soreness is not required each time you train, but out of the different types I’m going to describe it is the most desirable one. If you trained your glutes on Monday, and on Tuesday your glutes are sore, it’s an indication that the novel stimulus has been directed at the target muscle group. If you’re sore in your biceps after training glutes, that’s a problem.

To develop strength (hypertrophy), you don’t always need to be sore. It is not an indication that you had a successful lifting session.

Said another way: If you’re NOT sore in your glutes on Tuesday when you trained them on Monday, it doesn't necessarily mean nothing happened.

This is normal to feel or not to feel. I love it when I can feel some muscle soreness, but I don’t hinge the success of my lifting session based on it.

Joint, Tendon, Connective Tissue Fatigue / Soreness

This is soreness originating from the joints, connective tissues, or tendons.

We really want to minimize this type of soreness both during the workout and in the recovery period afterward. Feeling pain or soreness in these elements can indicate that there may be a technique issue with compensatory movement patterns present.

For example,  you really shouldn’t feel pain in your shoulder joint when doing a side lateral raise, or pain in your knee when doing a squat. If you are, it is a possible indication of aberrant mechanics during the move itself. This partially translates the force to the non-contractile tissue. This could be muscle movement patterning, a lack of mobility at the joints themselves, or both. It could also be that for your biomechanics, that particular movement isn’t optimal for YOU. There are many other ways to shred your legs and grow your shoulders.

You want this type of fatigue and soreness to be as close to zero as possible. It is certainly not normal to be feeling this kind of soreness all the time.

Axial Fatigue / Soreness

This is the fatigue and soreness through the spine and back from spinal loading.

It’s anything that loads weight on your spine top to bottom (e.g., putting a barbell on your back) or from hinge movements like a deadlift where a lot of the lower, mid, and upper back muscles, as well as the deep muscles of the back, are involved in stabilizing and executing the movement.

While not inherently good or bad, we want to be mindful of excessive axial loading being the limiting factor in lower limb progression.

For example, when I’m training my legs, I have to be mindful in between sets that both legs are sufficiently recovered AS WELL AS my lower back before I start again. My glutes can be ready, but if my lower back still needs a minute I wait until any secondary mover (in this example my lower back) is ready again. Otherwise, it’s going to be my back that limits my execution, energy, and form on the next set.

Your back is designed to carry heavy loads and with training, you will necessarily experience some axial loading. Fatigue is normal.

Ensure you’re 1) giving yourself sufficient rest in between sets, and 2) giving yourself adequate time between leg days.

Overall or Systemic Fatigue

This is the fatigue that occurs after too many days of poor recovery. It can be many weeks or months before you feel the effects.

You might notice that you begin to experience brain fog after workouts, or you’re generally less excited about training in general.

Other markers like poor sleep, excess or prolonged soreness, or any other types of fatigue above are beyond what you would consider normal.

This lack of desire when you have been able to demonstrate a consistent training schedule in the past is usually a gentle reminder to take a break.

A lot of women dealing with autoimmune conditions might experience systemic fatigue when they have pushed it too far in the gym. Learning how to stimulate — not annihilate — your muscles when dealing with an autoimmune condition might be tricky, but it’s fundamental to train at 40–50% less capacity so you don’t overwhelm an already overwhelmed immune system.

When you experience overall fatigue like this, it might be time for a deload week (another topic I will be exploring), or taking a few days off altogether.

What I Recommend: LMNT

Because you lose water and sodium when you sweat, you have to replace it. The water? Pretty easy. The sodium? It's got to be the right kind of electrolyte mix. LMNT combines sodium, potassium, and magnesium. This trio helps prevent muscle cramps, headaches, and energy dips.

For my Bettys in a cold climate, your hydration needs go up in winter. And while I'm truly a fan of LMNT's limited-edition Chocolate Medley for hot drinks, the Chocolate Mint was a surprise. (I actually don't like chocolate mint anything.) I wanted give it a fair shot, though, and ended up loving the taste. I mixed it with hot water. Super simple and the perfect complement to a snowy day at home this past week.

For my Bettys in a hotter climate, you'll want to try the Watermelon for some refreshingly fruity, zero-sugar hydration.

When you go to drinklmnt.com/drestima, you'll get a free LMNT Sample Pack of flavors with your order. I know you all love recipes, so be sure to visit LMNT's “Recipes” section for some salty inspo.

P.S.

HEALTH TOOLKIT: I've put together a toolkit for you on my brand new website. I designed these resources for my Bettys who are menstruating, experiencing perimenopause or have gone through menopause. There are commonalities between the categories and also specifics for each one. Everything I recommend, I use myself. That's my rule. I invite you to take a look!

Mini Pause #1: You Can Eat Oats. Yes, Really.

Posted on by stephanie-estima

Welcome to the The Mini Pause!

This is your weekly roundup of the BEST actionable steps for women 40+ who want to gain control of their hormones during perimenopause and menopause.

I am going to get back to what I love — teaching. I get to research, write, and then share evidence-based strategies for you to apply however you see fit! 

How you can get the most out of this newsletter:

  • You can either luxuriate in the details, or just skip to the good stuff.  
  • At the top of each newsletter you will find the summary, lovingly entitled TL,DR  (short for “too long, didn't read”). Skim that for the general topics covered in the newsletter.
  • Just want to know how you can make use of the info? Go to the HOW and NOW sections below to get the specific tools or action steps to try.
  • Want the know everything? Read it top to bottom, click the links and resources, and reply to this email with your feedback.

Whatever you have time for, and whatever your inclination, I'm here for all of it.

Let's begin.

Oats: Toxic Peasant Grub or Muscle Food?

TL,DR (too long, didn't read)

Oatmeal is not as bad a food as some influencers online would have you believe. It’s a surprisingly good source of protein, fibre, minerals, and a great option for pre-workout fuel. Oats with protein before a lift session also will improve your performance. There's a reason many bikini competitors and bodybuilders have oatmeal as a staple in their diet.

WHY

There's also a lot of discussion online about oats and the merits of its consumption. Some have called it peasant food, others call it a toxic soup that “steals” your nutrients, with the basic premise being that it should never be consumed.

Or…should it?

If you want to improve your performance at the gym-leading to all those muscle gains), it’s worth considering oats as a staple in your pre-workout arsenal.

WHAT

In the grain family, oats are the heavyweight champ for fibre. Whole oats clock in at about 11% fibre. If the name of the game is a long, healthy life, you want fibre in your diet and lots of it. Aim for 25g daily.

Fibre has a multitude of benefits; it:

  • regulates appetite by making you feel fuller, longer. That, in turn, regulates your calorie intake.
  • reduces total peaks and valleys of blood glucose levels, which improves your insulin sensitivity, mood, and energy swings.
  • lowers the risk of cardiovascular disease (the No. 1 killer of women).
  • improves lipid profiles (like total cholesterol numbers, LDL(c), and Triglycerides)
  • reduces blood pressure.

Oats contain many minerals that can help you with energy, mood, and sleep. They're high in iron, magnesium, and potassium — all crucial minerals every woman needs.

In a 50g packet of oats, you get 34% of your daily magnesium requirement (clocking in at about 135 mg per serving), 15% of your daily iron requirement, and 5% of your daily potassium requirement.

Finally, while oats are not usually considered “high protein,” they actually DO have a pretty decent amount of protein compared to other grains. A 50g serving has 8g of protein! While oats are mainly carbohydrates (that same serving size has 28g of carbohydrates, with 6g of fiber) — it’s still a decent amount of protein for a grain.

HOW

To maximize the benefits of oats, eat them with some protein 45 minutes to an hour before your workout. The easiest way I do this (especially for my morning lifts), is to combine 1 scoop of protein powder with some instant oats. Simple. Easy. No mess or prep.

If you’re feeling like a Domestic Goddess, here’s my tried and tested Overnight Oats recipe:

  • ½ cup oats
  • 1 scoop chocolate protein powder (like EquipFoods or Schinoussa)
  • ½ cup Greek yoghurt
  • ½ cup milk (of your choice)
  • Sprinkle of chocolate chips

This makes 1 serving. (I usually quadruple this recipe to have pre-workout fuel over four days.)

This will render about 309 calories, 46g of protein, 20g net carbs, and 4g of fat. For pre-workout fuel, this is the perfect carbs and protein combo to feed those working muscles! If you want to bulk up the fat, you can add 1 Tbsp of nut butter, too.

NOW

Try some protein and carbs before your next few lift sessions and see if you notice a difference in your performance. Prep the Overnight Oats recipe above, or just pour water over some instant oats and add in your favorite protein.

I lifted fasted for years but I have abandoned it as of late as there is a distinct difference in performance when I’m fed vs. when I’m fasted.  

Question of the Week

Q: How do I measure my hormone levels and at what point do we start taking hormones?

 

I love this question! It's a great one to kick off this newsletter.

EVALUATING

Ideally you would start measuring hormone levels in your 20s so you can take baseline levels of your estrogen (the main one being estradiol), testosterone, and progesterone. This is easily done through blood work. There are urine tests like the DUTCH (the DUTCH complete or the Sex Hormone test) that also can evaluate these hormones and their metabolites.

Irrespective of the way you measure, you want to be evaluating the relationship between estradiol and progesterone in the second half, or luteal phase, of your menstrual cycle. 

In other words, you want to evaluate: “What does my progesterone look like relative to my estradiol after I ovulate?”  

If you have MORE estradiol than progesterone in the luteal phase, this can set you up for a greater risk for fibrocystic breasts, uterine fibroids, endometriosis, breast pain, and horrible PMS. This is precisely what I wrote about in my book, The Betty Body.

It will also tend to make perimenopause symptoms worse, as early stages of perimenopause you have naturally declining levels of progesterone. This natural decline can make an already imbalanced estradiol-progesterone relationship worse.

TESTING & NEXT STEPS

So to answer the “how” part of your question — blood testing is great for most as it is the most accessible and you can take several blood draws over a month if need be.

If you are financially able, a DUTCH test can provide further information about how you process the estrogens in your body (there are certain pathways that are more troublesome than others). You can also evaluate DHEAs and the androgen pathways there, as well.

If you are in your 20s or 30s with a regular cycle, I typically recommend making your appointment on Day 21-22 of your cycle to try and capture peak progesterone. If your cycle is longer than 28 days, you want to be capturing progesterone about a week before your bleed week.

For women who are more irregular in their cycle, this becomes harder to figure out when “peak progesterone” occurs because the cycle tends to be shorter. Let's say your cycle is 25 days in length, you would take the test about six days before the onset of your period (25 days/4 = 6.25).

If you have not been diligent since your 20s, start getting yearly blood work now. Aim to do a complete blood workup every six months so  you can detect any patterns of change. For most of women, progesterone levels decline first — so that's an easy “tell” that things are changing.

Taking hormones should be evaluated for the individual, so there is no hard timeline for you to start. Depending on your history, your current symptoms, your quality of life, and your blood/urine data, this should be a conversation you have with your primary health care provider.

YOUR TURN!

I'll be answering your questions every week right here in the Mini Pause! Let me know what's on your mind. I'll be checking for both questions and feedback at support@drstephanieestima.com.

What I Recommend: AG1

This drink covers my bases when I don't have time to chop all my veggies. I scoop, mix with water, and my daily nutrients are done! I am a supplement minimalist and AG1 tics all the boxes for me: comprehensive, convenient, and easy.

One daily serving of AG1 delivers a potent blend of nine health products—a multivitamin, minerals, probiotics, adaptogens, and more. It's the comprehensive, foundational nutrition you need with the convenience your life demands.

Use this link to order and receive a FREE One Year Supply of Vitamin D3+K2 and 5 Travel Packs!

Dr. Stephanie